Baraba Ranka, Sruk Ana, Sragalj Ljiljana, Butković-Soldo Silva, Bielen Ivan
University Department of Neurology, Sveti Duh University Hospital, Zagreb, Croatia.
Acta Clin Croat. 2011 Jun;50(2):201-7.
The aim of the study was to identify the most common electrophysiological abnormalities in early Guillain-Barré syndrome (GBS). Neurophysiological data on 51 GBS patients assessed within 12 days of symptom onset were reviewed. Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) was present in 46 of 51 GBS patients. The following abnormalities were observed in our AIDP patients: absent H reflex in 90.7%, conduction block in the Erb-to-axilla segment in 78.6%, motor conduction velocity suggestive of demyelination in the Erb-to-axilla segment in 45.2%, prolonged F wave latency in 65.2%-73.8% of patients but only 20.0%-37.0% with prolonged F wave latency suggestive of demyelination, and reduced or absent sensory nerve action potential in 62% of patients. Abnormal values of terminal latencies, and motor and sensory conduction velocities in distal nerve segments suggestive of demyelination were recorded in less than 30% of patients. In conclusion, the most sensitive parameter in early GBS patients is conduction block in the most proximal segments of the peripheral nervous system, directly determined in the Erb-to-axilla segment or indirectly as absent H reflex. Motor conduction studies in the Erb-to-axilla segment are very informative in early GBS patients.
该研究的目的是确定早期吉兰-巴雷综合征（GBS）中最常见的电生理异常。回顾了51例在症状出现后12天内接受评估的GBS患者的神经生理学数据。51例GBS患者中有46例存在急性炎症性脱髓鞘性多发性神经根神经病（AIDP）。在我们的AIDP患者中观察到以下异常：90.7%的患者H反射消失，78.6%的患者在Erb点至腋窝段存在传导阻滞，45.2%的患者在Erb点至腋窝段运动传导速度提示脱髓鞘，65.2%-73.8%的患者F波潜伏期延长，但只有20.0%-37.0%的患者F波潜伏期延长提示脱髓鞘，62%的患者感觉神经动作电位降低或消失。不到30%的患者记录到远端神经段提示脱髓鞘的终末潜伏期、运动和感觉传导速度异常值。总之，早期GBS患者中最敏感的参数是外周神经系统最近端节段的传导阻滞，可直接在Erb点至腋窝段测定或间接通过H反射消失来确定。在早期GBS患者中，Erb点至腋窝段的运动传导研究非常有意义。
